BACKGROUND Breast hamartomas are rare benign breast tumors,with an incidence rate of 0.8%-4.8%.Further,the coexistence of hamartomas and carcinoma is also uncommon.Our case report presents a unique instance where inva...BACKGROUND Breast hamartomas are rare benign breast tumors,with an incidence rate of 0.8%-4.8%.Further,the coexistence of hamartomas and carcinoma is also uncommon.Our case report presents a unique instance where invasive ductal carcinoma(IDC)and ductal carcinoma in situ were found both inside and outside a breast hamartoma.This is the second case reported in the literature.CASE SUMMARY A 51-year-old woman presented with a 6.0 cm breast tumor on mammography and ultrasound,with suspicious areas indicative of malignant transformation.Biopsy of the suspicious area confirmed IDC with intraductal carcinoma.Breast magnetic resonance imaging showed typical hamartoma changes with irregular areas of abnormal enhancement both inside and outside.A breast-conserving surgery was performed,and postoperative pathology confirmed mammary hamartoma,concurrent with IDC and intraductal carcinoma occurring both inside and outside the hamartoma.Subsequently,appropriate adjuvant therapy was initiated.Currently,the patient is in good condition.Breast cancer may be located both inside and outside the ipsilateral mammary hamartoma,which is difficult to detect preoperatively,especially when there is a focus of intraductal carcinoma,requiring accurate assessment of the tumor extent by modern imaging techniques.Early detection of the coexistence of cancer is clinically important as it can alter patient management.CONCLUSION This case emphasizes the importance of modern imaging techniques in accurately evaluating mammary hamartomas associated with malignancies prior to surgery.展开更多
Objective： To detect the expression of VEGF and MVD count in invasive ductal carcinoma of breast to clarify the association of VEGF expression and MVD count with the clinicopathologic features. Methods： The expressi...Objective： To detect the expression of VEGF and MVD count in invasive ductal carcinoma of breast to clarify the association of VEGF expression and MVD count with the clinicopathologic features. Methods： The expressions of VEGF, ER, PR, C-erbB-2 and MVD count in 88 cases of invasive ductal carcinoma of breast were examined by immunohistochemistry staining （SP-method）. Results： Sixty-two out of the eighty-eight specimens of breast carcinoma （70.45%） showed positive expression of VEGF. The positive rate of VEGF in cases with lymph node metastasis was higher than that without lymph node metastasis （P〈0.05）. The positive rate of VEGF in stage IIb-Ⅲ was higher than that in stage Ⅰ-Ⅱa （P〈0.05）. The positive rate of VEGF in C-erbB-2 positive group was higher than that in C-erbB-2 negative group （P〈0.05）. Higher expression of VEGF was observed in cases with higher tissue differentiation degree （P〈0.05）. Also, significant higher MVD count was observed in cases with higher tissue differentiation degree （P〈0.01）. The MVD count increased significantly with the increase of the expression of VEGF （P〈0.01）. Conclusion： The result of this study suggested that in invasive ductal carcinoma of breast, angiogenesis and metastasis were mediated mainly by VEGF. The expression of VEGF and MVD might be reference predictors for the biological behavior of breast carcinoma. The antiangiogenic therapy which used VEGF as a target would become a new method to treat patients who were C-erbB-2 positive in the future.展开更多
The correlations between shear wave velocity(SWV)calculated from virtual touch tissue imaging quantification(VTIQ)technique and histological prognostic factors of invasive ductal carcinoma was investigated.A total of ...The correlations between shear wave velocity(SWV)calculated from virtual touch tissue imaging quantification(VTIQ)technique and histological prognostic factors of invasive ductal carcinoma was investigated.A total of 76 breast tumors histologically confirmed as invasive ductal carcinomas were included in this study.SWV values were measured by VTIQ for each lesion preoperatively or prior to breast biopsy.The maximum values were recorded for statistical analysis.Medical records were reviewed to determine tumor size,histological grade,lymph node status and immunohistochemical results.Tumor subtypes were categorized as luminal A,luminal B,human epidermal growth factor receptor 2(HER2)positive and triple negative.The correlations between SWV and histological prognostic factors were analyzed.It was found that tumor size showed positive association with SWV(r=0.465,P<0.001).Larger tumors had significantly higher SWV than smaller ones(P=0.001).Histological grade 1 tumors had significantly lower SWV values than those with higher histological grade(P=0.015).The Ki67 expression,tumor subtypes and lymph node status showed no statistically significant correlations with SWV,although triple negative tumors and lymph node-positive tumors showed higher SWV values.It was concluded that tumor size was significantly associated with SWV.Higher histological grade was associated with increased SWV.There was no statistically significant correlations between SWV and other histological prognostic factors.展开更多
Low-grade invasive ductal carcinoma is almost diploid, and has frequent losses of chromosome 16q, which is shared by other precancerous lesions of the mammary gland such as flat epithelial atypia （FEA）, atypical duc...Low-grade invasive ductal carcinoma is almost diploid, and has frequent losses of chromosome 16q, which is shared by other precancerous lesions of the mammary gland such as flat epithelial atypia （FEA）, atypical ductal hyperplasia （ADH）, and lownuclear grade ductal carcinoma in situ （DCIS）. The genetic alterations accumulate in a stepwise fashion as the precancerous lesions progress to invasve ductal carcinoma. This supports the linear progression model of breast cancer from FEA, through ADH, to low- nuclear grade DCIS as non-obligate early events in low-grade IDC evolution. In contrast, high-grade carcinoma tends to aneuploidy with complex genetic alterations--most importantly, frequent gains at chromosome 16q. Frequent losses at chromosome 16q in low-grade IDC and gains in the same arm of the same chromosome in high-grade IDC imply that these lesions are two end outcomes of different disease processes and that they do not lie in the same continuum of a process. Therefore, low-grade and high-grade IDC are two distinct diseases with a divergent route of progression.展开更多
This report describes serial observations of the growth process of a small invasive ductal carcinoma (IDC) of the pancreas from imaging studies. Histopathological studies showed IDC with macroscopic retention cysts pr...This report describes serial observations of the growth process of a small invasive ductal carcinoma (IDC) of the pancreas from imaging studies. Histopathological studies showed IDC with macroscopic retention cysts proximal to an intraductal papillary-mucinous adenoma with mild atypia of the branch duct type in the pancreatic body, with no relation between the two lesions. IDC was demonstrated as an extremely low-echoic mass resembling a cyst with an unclear margin on the initial endoscopic ultrasonography. We misinterpreted the low-echoic mass as a benign intraductal mucinous-papillary neoplasm (IPMN) based on findings of other imaging studies, and the patient was followed-up. The mass increased from 7 mm to 13 mm in diameter over 22 mo, and remained smaller than 10 mm in diameter for about 420 d. The tumor volume doubling time was 252 d. The Ki67 labeling index was 15.9%, similar to that described in previous reports. Hence, IDC may grow slowly while remaining small.展开更多
Male breast disorders,though less prevalent,present unique diagnostic cha-llenges that differ significantly from their female counterparts.While benign entities such as gynecomastia are predominant,the risk of underly...Male breast disorders,though less prevalent,present unique diagnostic cha-llenges that differ significantly from their female counterparts.While benign entities such as gynecomastia are predominant,the risk of underlying malig-nancy,often diagnosed at an advanced stage,highlights the need for a systematic,image-guided assessment.Ultrasound and mammography are the first-line complementary tools,with magnetic resonance imaging reserved for problem-solving.This review outlines the anatomical,pathological,and radiological nu-ances of the male breast,describing crucial red flag signs,sonographic pitfalls,and mammographic mimics that aid in distinguishing benign entities from si-nister pathologies such as invasive ductal carcinoma.Given the increasing visi-bility of transgender individuals,this review also addresses imaging consider-ations and screening recommendations tailored to this population.By integrating clinical insights with radiologic imaging,this review offers a comprehensive approach to both common and not-so-common male breast lesions,with an em-phasis on an algorithmic stepwise diagnostic approach.展开更多
BACKGROUND Breast cancer is a leading cause of cancer-related mortality among women worldwide,with invasive ductal carcinoma(IDC)being the most prevalent subtype.Lymph node metastasis is the primary prognostic indicat...BACKGROUND Breast cancer is a leading cause of cancer-related mortality among women worldwide,with invasive ductal carcinoma(IDC)being the most prevalent subtype.Lymph node metastasis is the primary prognostic indicator,typically evaluated via biopsy of the ipsilateral sentinel or axillary lymph nodes.Contralateral axillary metastasis(CAM)without ipsilateral involvement is exceedingly rare,particularly in early-stage breast cancer.This report presents a case of CAM in a patient with triple-negative breast cancer(TNBC),underscoring diagnostic and therapeutic complexities.CASE SUMMARY A 73-year-old female presented with left-sided early-stage IDC in February 2023.Despite a modified radical mastectomy and pathologically negative ipsilateral lymph nodes,a postoperative positron emission tomography(PET)scan detected fluorodeoxyglucose-avid nodes in the contralateral axilla.Biopsy confirmed metastatic ductal carcinoma with triple-negative status,resulting in an upstaged diagnosis of metastatic breast cancer,stage IV,M1.The patient underwent six cycles of adjuvant chemotherapy,with follow-up PET imaging showing regression of the contralateral lesion.This case highlights the importance of advanced imaging in TNBC for precise staging and treatment optimization.CONCLUSION This case highlights the aggressive nature of TNBC and the need for advanced imaging to ensure accurate staging and effective management.展开更多
Background:The Fn14 fibroblast growth factor-inducible 14(Fn14)can stimulate cell migration and promote cancer lessions.Progranulin(GP88)protein has been identified as an epidermal growth factor and participates in ma...Background:The Fn14 fibroblast growth factor-inducible 14(Fn14)can stimulate cell migration and promote cancer lessions.Progranulin(GP88)protein has been identified as an epidermal growth factor and participates in many biological processes.The aim of the present work was to investigate the immunohistochemical expression of Fn14 and GP88 proteins in relation to the clinical parameters in women's invasive ductal carcinoma(IDC)and to explore their role as novel prognostic biomarkers.Methods:The qualitative and quantitative immunohistochemical techniques were used to evaluate the expression levels of Fn14 and GP88 in 100 fresh samples of Egyptian women who had breast lesions.They were divided into three groups:control healthy tissues(10 samples from woman lesions),benign group(30 cases),and IDC group(60 cases).Results:The histopathological results of 60 cases with IDC have been reported with 45 cases being gradeⅡand 15 cases being gradeⅢ.The immunohistochemical results showed that the degree of strong positive staining for both markers was increased in gradeⅢcompared to that in gradeⅡ.The integrated optical density was significantly increased in gradeⅢ(p<0.05).Also,the result revealed a highly significant correlation between the two markers and the tumor size,grades,and lymph node metastasis,as well as a correlation to normal and benign breast lesions.Conclusion:The quantitative immunohistochemistry of Fn14 and GP88 proteins revealed the correlation between the two markers and clinical parameters.Therefore,the two markers may be serviceable as prognostic and therapeutic markers in IDC patients.展开更多
Ductal carcinoma in situ （DCIS） is a category of early stage, non-invasive breast tumor defined by the intraductal proliferation of malignant breast epithelial cells. DCIS is a heterogeneous disease composed of mult...Ductal carcinoma in situ （DCIS） is a category of early stage, non-invasive breast tumor defined by the intraductal proliferation of malignant breast epithelial cells. DCIS is a heterogeneous disease composed of multiple molecular subtypes including luminal, HER2 and basal-like types, which are characterized by immuno-histochemical analyses and gene expression profiling. Following surgical and radiation therapies, patients with luminal-type, estrogen receptor-positive DCIS breast tumors can benefit from adjuvant endocrine-based treatment. However, there are no available targeted therapies for patients with basal-like DCIS （BL-DCIS） tumors due to their frequent lack of endocrine receptors and HER2 amplification, rendering them potentially susceptible to recurrence. Moreover, multiple lines of evidence suggest that DCIS is a non-obligate precursor of invasive breast carcinoma. This raises the possibility that targeting precursor BL-DCIS is a promising strategy to prevent BL-DCIS patients from the development of invasive basal-like breast cancer. An accumulating body of evidence demonstrates the existence of cancer stem-like cells （CSCs） in BL-DCIS, which potentially determine the features of BL-DCIS and their ability to progress into invasive cancer. This review encompasses the current knowledge in regard to the characteristics of BL-DCIS, identifcation of CSCs, and their biological properties in BL-DCIS. We summarize recently discovered relevant molecular signaling alterations that promote the generation of CSCs in BL-DCIS and the progression of BL-DCIS to invasive breast cancer, as well as the infuence of the tissue microenvironment on CSCs and the invasive transition. Finally, we discuss the translational implic-ations of these fndings for the prognosis and prevention of BL-DCIS relapse and progression.展开更多
An increasing body of evidence supports a stepwise model for progression of breast cancer from ductal carcinoma in situ(DCIS) to invasive ductal carcinoma(IDC). Due to the high level of DCIS heterogeneity, we cannot c...An increasing body of evidence supports a stepwise model for progression of breast cancer from ductal carcinoma in situ(DCIS) to invasive ductal carcinoma(IDC). Due to the high level of DCIS heterogeneity, we cannot currently predict which patients are at highest risk for disease recurrence or progression. The mechanisms of progression are still largely unknown, however cancer stem cell populations in DCIS lesions may serve as malignant precursor cells intimately involved in progression. While genetic and epigenetic alterations found in DCIS are often shared by IDC, m RNA and mi RNA expression profiles are significantly altered. Therapeutic targeting of cancer stem cell pathways and differentially expressed mi RNA could have significant clinical benefit. As tumor grade increases, mi RNA-140 is progressively downregulated. mi R-140 plays an important tumor suppressive role in the Wnt, SOX2 and SOX9 stem cell regulator pathways. Downregulation of mi R-140 removes inhibition of these pathways, leading to higher cancer stem cell populations and breast cancer progression. mi R-140 downregulation is mediated through both an estrogen response element in the mi R-140 promoter region and differential methylation of Cp G islands. These mechanisms are novel targets for epigenetic therapy to activate tumor suppressor signaling via mi R-140. Additionally, we briefly explored the emerging role of exosomes in mediating intercellular mi R-140 signaling. The purpose of this review is to examine the cancer stem cell signaling pathways involved in breast cancer progression, and the role of dysregulation of mi R-140 in regulating DCIS to IDC transition.展开更多
BACKGROUND Metaplastic breast carcinoma(MBC)is a rare subtype of invasive breast cancer comprising malignant epithelial and mesenchymal cells.Compared with other invasive breast cancers,MBC is not only histologically ...BACKGROUND Metaplastic breast carcinoma(MBC)is a rare subtype of invasive breast cancer comprising malignant epithelial and mesenchymal cells.Compared with other invasive breast cancers,MBC is not only histologically distinctly heterogeneous but also has a rapid and aggressive growth pattern,which leads to a significant risk of recurrence and mortality.CASE SUMMARY In this study,we report the case of a patient with a large left breast mass diagnosed with bilateral invasive ductal carcinoma in both breasts after a preoperative core needle aspiration biopsy of the bilateral breast mass.The patient received neoadjuvant chemotherapy and underwent bilateral breast modified radical mastectomy.Postoperative pathology suggested carcinosarcoma with predominantly chondrosarcoma in the left breast and invasive ductal carcinoma(luminal B)in the right breast.As the patient did not achieve complete pathological remission after six cycles of neoadjuvant chemotherapy,we administered six months of intensive capecitabine treatment.Then the patient was switched to continuous treatment with endocrine therapy using letrozole+goserelin,and the patient is currently in stable condition.However,as MBC of the breast is concurrently diagnosed with chondrosarcoma differentiation,our case is sporadic.CONCLUSION Given the variety of immunohistochemical types of bilateral breast cancer,achieving effective chemotherapy should be a key research focus.展开更多
Breast cancer is the second leading cancer in the world. <span style="font-family:Verdana;">The long-term</span><span style="font-family:Verdana;"> exposure </span><span ...Breast cancer is the second leading cancer in the world. <span style="font-family:Verdana;">The long-term</span><span style="font-family:Verdana;"> exposure </span><span style="font-family:Verdana;">of</span><span style="font-family:Verdana;"> some metallic compounds induces different forms of cancer, including breast cancer. Trace elements are essential metals for the physiological functions of the cell on a molecular level and also contribute </span><span style="font-family:Verdana;">in</span> <span style="font-family:Verdana;">treatment</span><span style="font-family:Verdana;"> of many diseases. </span><span style="font-family:Verdana;">The aim of study was</span><span style="font-family:Verdana;"> to compare the level of essential trace elements, sodium, potassium, calcium, iron, and zinc in breast cancer patients with normal healthy adult women. Total forty-five patients (age range from 25</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">-</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">73 years) were included in this study and divided into three groups according to three different stages of breast cancer including tumor-II, tumor-III </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> tumor-IV. Blood was collected from all participants after taking history, clinical data </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> taking consent. However, about fifteen non-cancer healthy women in </span><span style="font-family:Verdana;">age</span><span style="font-family:Verdana;"> range from 26</span></span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">-</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">69 years were subjected to this study. The elemental concentrations were determined through atomic absorption spectrophotometer </span><span style="font-family:Verdana;">subsequent to</span><span style="font-family:Verdana;"> microwave-induced acid digestion. The results of Na, K, Zn, Fe, Ca, were observed </span></span><span style="font-family:Verdana;">to </span><span style="font-family:Verdana;">decrease in blood samples of breast cancer patients as compared to non-cancer subjects. The results are reliable with other numerous literature reported studies, the efficiency, and deficiency of these trace metals may contribute </span><span style="font-family:Verdana;">an </span><span style="font-family:Verdana;">important</span><span style="font-family:Verdana;"> role in the progress of breast cancer.</span>展开更多
Breast cancer,particularly Invasive Ductal Carcinoma(IDC),is a primary global health concern predominantly affecting women.Early and precise diagnosis is crucial for effective treatment planning.Several AI-based tech-...Breast cancer,particularly Invasive Ductal Carcinoma(IDC),is a primary global health concern predominantly affecting women.Early and precise diagnosis is crucial for effective treatment planning.Several AI-based tech-niques for IDC-level classification have been proposed in recent years.Processing speed,memory size,and accuracy can still be improved for better performance.Our study presents ECAM,an Enhanced Channel-Wise Attention Mechanism,using deep learning to analyze histopathological images of Breast Invasive Ductal Carcinoma(BIDC).The main objectives of our study are to enhance computational efficiency using a Separable CNN architecture,improve data representation through hierarchical feature aggregation,and increase accuracy and interpretability with channel-wise attention mechanisms.Utilizing publicly available datasets,DataBioX IDC and the BreakHis,we benchmarked the proposed ECAM model against existing state-of-the-art models:DenseNet121,VGG16,and AlexNet.In the IDC dataset,the model based on AlexNet achieved an accuracy rate of 86.81%and an F1 score of 86.94%.On the other hand,DenseNet121 outperformed with an accuracy of 95.60%and an F1 score of 95.75%.Meanwhile,the VGG16 model achieved an accuracy rate of 91.20%and an F1 score of 90%.Our proposed ECAM model outperformed the state-of-the-art,achieving an impressive F1 score of 96.65%and an accuracy rate of 96.70%.The BreakHis dataset,the AlexNet-based model,achieved an accuracy rate of 90.82%and an F1 score of 90.77%.DenseNet121 achieved a higher accuracy rate of 92.66%with an F1 score of 92.72%,while the VGG16 model achieved an accuracy of 92.60%and an F1 score of 91.31%.The proposed ECAM model again outperformed,achieving an F1 score of 96.37%and an accuracy rate of 96.33%.Our model is a significant advancement in breast cancer diagnosis,with high accuracy and potential as an automated grading,especially for IDC.展开更多
The present study aimed to investigate the possibility of using dual-energy computed tomography (CT) before therapy to discriminate between normal breast tissue and tumor tissue in patients with breast cancer, without...The present study aimed to investigate the possibility of using dual-energy computed tomography (CT) before therapy to discriminate between normal breast tissue and tumor tissue in patients with breast cancer, without the need to use a contrast medium. The following patient data were extracted by interview and from the hospital’s radiology information system: height, weight, age, menstrual cycle, CT images of normal tissue and tumors with or without contrast medium, and the histopathological diagnosis of the aspiration biopsy. The median age of the 43 participants was 56 years (range, 30 - 80 years). The CT values were evaluated using a clinical analytical program based on the three-material decomposition technique. Breast cancer was classified into ductal carcinoma in situ, invasive ductal carcinoma, invasive lobular carcinoma, fibromatosis-like metaplastic carcinoma, and apocrine carcinoma. In all conditions, regardless of contrast medium, the CT values of tumor tissues were higher than those of normal breast tissue, indicating the effectiveness of dual-energy CT (DE-CT) in the diagnosis of breast cancer. By contrast, DE-CT showed limited potential for distinguishing ductal carcinoma in situ from invasive ductal carcinoma. There have only been a few reports regarding CT examination of breast cancer, and it is expected this study encourage the development of DE-CT imaging to improve tumor detection in patients with breast cancer.展开更多
Background： Blood oxygenation level-dependent magnetic resonance imaging （BOLD-MRI） is a functional MRI technique which involves using the paramagnetic properties of deoxyhemoglobin to image the local tissue oxygen...Background： Blood oxygenation level-dependent magnetic resonance imaging （BOLD-MRI） is a functional MRI technique which involves using the paramagnetic properties of deoxyhemoglobin to image the local tissue oxygen concentration. The purpose of this study was to investigate whether BOLD-MRI could evaluate hypoxia and angiogenesis of breast invasive ductal carcinoma （IDC）. Methods： Ninety-eight female patients with IDC were retrospectively included in this research. All patients underwent breast BOLD-MRI at 3.0 T before surgery. R2＊ values of BOLD-MR1 were measured. The expression of carbonic anhydrase IX （CA IX） and vascular endothelial growth factor （VEGF） was analyzed by immunohistochemistry. Spearman＇s correlation analysis was used to correlate R2＊ value with CA IX and VEGF levels. Results： Heterogeneous intensity on BOLD-MRI images was the main finding of IDCs. The mean R2＊ value was 52.8 ± 18.6 Hz. The R2＊ values in patients with axillary lymph node metastasis were significantly higher than the R2＊ values in patients without axillary lymph node metastasis （t = 2.882, P = 0.005）. R2＊ values increased with CA IX level and positively correlated with the level of CA 1X （r = 0.616, P 〈 0.001）; however, R2＊ value had no significantly correlation with the level of VEGF （r = 0.110, P = 0.281）. Conclusion： B OLD-MRI could noninvasively evaluate chronic hypoxia of IDC, but not angiogenesis.展开更多
基金Supported by Jilin City Science and Technology Innovation Development Plan Project,China,No.20230406201Jilin Province Traditional Chinese Medicine Technology Project,China,No.2024159.
文摘BACKGROUND Breast hamartomas are rare benign breast tumors,with an incidence rate of 0.8%-4.8%.Further,the coexistence of hamartomas and carcinoma is also uncommon.Our case report presents a unique instance where invasive ductal carcinoma(IDC)and ductal carcinoma in situ were found both inside and outside a breast hamartoma.This is the second case reported in the literature.CASE SUMMARY A 51-year-old woman presented with a 6.0 cm breast tumor on mammography and ultrasound,with suspicious areas indicative of malignant transformation.Biopsy of the suspicious area confirmed IDC with intraductal carcinoma.Breast magnetic resonance imaging showed typical hamartoma changes with irregular areas of abnormal enhancement both inside and outside.A breast-conserving surgery was performed,and postoperative pathology confirmed mammary hamartoma,concurrent with IDC and intraductal carcinoma occurring both inside and outside the hamartoma.Subsequently,appropriate adjuvant therapy was initiated.Currently,the patient is in good condition.Breast cancer may be located both inside and outside the ipsilateral mammary hamartoma,which is difficult to detect preoperatively,especially when there is a focus of intraductal carcinoma,requiring accurate assessment of the tumor extent by modern imaging techniques.Early detection of the coexistence of cancer is clinically important as it can alter patient management.CONCLUSION This case emphasizes the importance of modern imaging techniques in accurately evaluating mammary hamartomas associated with malignancies prior to surgery.
基金This project was supported by the Science and Technology Research and Development Program of Hebei Province (No. 0527611016).
文摘Objective： To detect the expression of VEGF and MVD count in invasive ductal carcinoma of breast to clarify the association of VEGF expression and MVD count with the clinicopathologic features. Methods： The expressions of VEGF, ER, PR, C-erbB-2 and MVD count in 88 cases of invasive ductal carcinoma of breast were examined by immunohistochemistry staining （SP-method）. Results： Sixty-two out of the eighty-eight specimens of breast carcinoma （70.45%） showed positive expression of VEGF. The positive rate of VEGF in cases with lymph node metastasis was higher than that without lymph node metastasis （P〈0.05）. The positive rate of VEGF in stage IIb-Ⅲ was higher than that in stage Ⅰ-Ⅱa （P〈0.05）. The positive rate of VEGF in C-erbB-2 positive group was higher than that in C-erbB-2 negative group （P〈0.05）. Higher expression of VEGF was observed in cases with higher tissue differentiation degree （P〈0.05）. Also, significant higher MVD count was observed in cases with higher tissue differentiation degree （P〈0.01）. The MVD count increased significantly with the increase of the expression of VEGF （P〈0.01）. Conclusion： The result of this study suggested that in invasive ductal carcinoma of breast, angiogenesis and metastasis were mediated mainly by VEGF. The expression of VEGF and MVD might be reference predictors for the biological behavior of breast carcinoma. The antiangiogenic therapy which used VEGF as a target would become a new method to treat patients who were C-erbB-2 positive in the future.
基金grants from the Fundamental Research Funds for the Central Universities(No.2172015YGYL019)the Fundamental Research Funds for the Central Universities(No.2015LC021)+1 种基金National Natural Science Foundation of China(No.81000616)Hubei Key Laboratory of Molecular Imaging Research Funds(No.02.03.2015-149).
文摘The correlations between shear wave velocity(SWV)calculated from virtual touch tissue imaging quantification(VTIQ)technique and histological prognostic factors of invasive ductal carcinoma was investigated.A total of 76 breast tumors histologically confirmed as invasive ductal carcinomas were included in this study.SWV values were measured by VTIQ for each lesion preoperatively or prior to breast biopsy.The maximum values were recorded for statistical analysis.Medical records were reviewed to determine tumor size,histological grade,lymph node status and immunohistochemical results.Tumor subtypes were categorized as luminal A,luminal B,human epidermal growth factor receptor 2(HER2)positive and triple negative.The correlations between SWV and histological prognostic factors were analyzed.It was found that tumor size showed positive association with SWV(r=0.465,P<0.001).Larger tumors had significantly higher SWV than smaller ones(P=0.001).Histological grade 1 tumors had significantly lower SWV values than those with higher histological grade(P=0.015).The Ki67 expression,tumor subtypes and lymph node status showed no statistically significant correlations with SWV,although triple negative tumors and lymph node-positive tumors showed higher SWV values.It was concluded that tumor size was significantly associated with SWV.Higher histological grade was associated with increased SWV.There was no statistically significant correlations between SWV and other histological prognostic factors.
文摘Low-grade invasive ductal carcinoma is almost diploid, and has frequent losses of chromosome 16q, which is shared by other precancerous lesions of the mammary gland such as flat epithelial atypia （FEA）, atypical ductal hyperplasia （ADH）, and lownuclear grade ductal carcinoma in situ （DCIS）. The genetic alterations accumulate in a stepwise fashion as the precancerous lesions progress to invasve ductal carcinoma. This supports the linear progression model of breast cancer from FEA, through ADH, to low- nuclear grade DCIS as non-obligate early events in low-grade IDC evolution. In contrast, high-grade carcinoma tends to aneuploidy with complex genetic alterations--most importantly, frequent gains at chromosome 16q. Frequent losses at chromosome 16q in low-grade IDC and gains in the same arm of the same chromosome in high-grade IDC imply that these lesions are two end outcomes of different disease processes and that they do not lie in the same continuum of a process. Therefore, low-grade and high-grade IDC are two distinct diseases with a divergent route of progression.
文摘This report describes serial observations of the growth process of a small invasive ductal carcinoma (IDC) of the pancreas from imaging studies. Histopathological studies showed IDC with macroscopic retention cysts proximal to an intraductal papillary-mucinous adenoma with mild atypia of the branch duct type in the pancreatic body, with no relation between the two lesions. IDC was demonstrated as an extremely low-echoic mass resembling a cyst with an unclear margin on the initial endoscopic ultrasonography. We misinterpreted the low-echoic mass as a benign intraductal mucinous-papillary neoplasm (IPMN) based on findings of other imaging studies, and the patient was followed-up. The mass increased from 7 mm to 13 mm in diameter over 22 mo, and remained smaller than 10 mm in diameter for about 420 d. The tumor volume doubling time was 252 d. The Ki67 labeling index was 15.9%, similar to that described in previous reports. Hence, IDC may grow slowly while remaining small.
文摘Male breast disorders,though less prevalent,present unique diagnostic cha-llenges that differ significantly from their female counterparts.While benign entities such as gynecomastia are predominant,the risk of underlying malig-nancy,often diagnosed at an advanced stage,highlights the need for a systematic,image-guided assessment.Ultrasound and mammography are the first-line complementary tools,with magnetic resonance imaging reserved for problem-solving.This review outlines the anatomical,pathological,and radiological nu-ances of the male breast,describing crucial red flag signs,sonographic pitfalls,and mammographic mimics that aid in distinguishing benign entities from si-nister pathologies such as invasive ductal carcinoma.Given the increasing visi-bility of transgender individuals,this review also addresses imaging consider-ations and screening recommendations tailored to this population.By integrating clinical insights with radiologic imaging,this review offers a comprehensive approach to both common and not-so-common male breast lesions,with an em-phasis on an algorithmic stepwise diagnostic approach.
文摘BACKGROUND Breast cancer is a leading cause of cancer-related mortality among women worldwide,with invasive ductal carcinoma(IDC)being the most prevalent subtype.Lymph node metastasis is the primary prognostic indicator,typically evaluated via biopsy of the ipsilateral sentinel or axillary lymph nodes.Contralateral axillary metastasis(CAM)without ipsilateral involvement is exceedingly rare,particularly in early-stage breast cancer.This report presents a case of CAM in a patient with triple-negative breast cancer(TNBC),underscoring diagnostic and therapeutic complexities.CASE SUMMARY A 73-year-old female presented with left-sided early-stage IDC in February 2023.Despite a modified radical mastectomy and pathologically negative ipsilateral lymph nodes,a postoperative positron emission tomography(PET)scan detected fluorodeoxyglucose-avid nodes in the contralateral axilla.Biopsy confirmed metastatic ductal carcinoma with triple-negative status,resulting in an upstaged diagnosis of metastatic breast cancer,stage IV,M1.The patient underwent six cycles of adjuvant chemotherapy,with follow-up PET imaging showing regression of the contralateral lesion.This case highlights the importance of advanced imaging in TNBC for precise staging and treatment optimization.CONCLUSION This case highlights the aggressive nature of TNBC and the need for advanced imaging to ensure accurate staging and effective management.
文摘Background:The Fn14 fibroblast growth factor-inducible 14(Fn14)can stimulate cell migration and promote cancer lessions.Progranulin(GP88)protein has been identified as an epidermal growth factor and participates in many biological processes.The aim of the present work was to investigate the immunohistochemical expression of Fn14 and GP88 proteins in relation to the clinical parameters in women's invasive ductal carcinoma(IDC)and to explore their role as novel prognostic biomarkers.Methods:The qualitative and quantitative immunohistochemical techniques were used to evaluate the expression levels of Fn14 and GP88 in 100 fresh samples of Egyptian women who had breast lesions.They were divided into three groups:control healthy tissues(10 samples from woman lesions),benign group(30 cases),and IDC group(60 cases).Results:The histopathological results of 60 cases with IDC have been reported with 45 cases being gradeⅡand 15 cases being gradeⅢ.The immunohistochemical results showed that the degree of strong positive staining for both markers was increased in gradeⅢcompared to that in gradeⅡ.The integrated optical density was significantly increased in gradeⅢ(p<0.05).Also,the result revealed a highly significant correlation between the two markers and the tumor size,grades,and lymph node metastasis,as well as a correlation to normal and benign breast lesions.Conclusion:The quantitative immunohistochemistry of Fn14 and GP88 proteins revealed the correlation between the two markers and clinical parameters.Therefore,the two markers may be serviceable as prognostic and therapeutic markers in IDC patients.
基金Supported by The National Cancer Institute(NCI)of National Institutes of Health(NIH)of the United States of America to Zhou Q,Nos.5R01CA157779-03 and 5R01CA163820-04
文摘Ductal carcinoma in situ （DCIS） is a category of early stage, non-invasive breast tumor defined by the intraductal proliferation of malignant breast epithelial cells. DCIS is a heterogeneous disease composed of multiple molecular subtypes including luminal, HER2 and basal-like types, which are characterized by immuno-histochemical analyses and gene expression profiling. Following surgical and radiation therapies, patients with luminal-type, estrogen receptor-positive DCIS breast tumors can benefit from adjuvant endocrine-based treatment. However, there are no available targeted therapies for patients with basal-like DCIS （BL-DCIS） tumors due to their frequent lack of endocrine receptors and HER2 amplification, rendering them potentially susceptible to recurrence. Moreover, multiple lines of evidence suggest that DCIS is a non-obligate precursor of invasive breast carcinoma. This raises the possibility that targeting precursor BL-DCIS is a promising strategy to prevent BL-DCIS patients from the development of invasive basal-like breast cancer. An accumulating body of evidence demonstrates the existence of cancer stem-like cells （CSCs） in BL-DCIS, which potentially determine the features of BL-DCIS and their ability to progress into invasive cancer. This review encompasses the current knowledge in regard to the characteristics of BL-DCIS, identifcation of CSCs, and their biological properties in BL-DCIS. We summarize recently discovered relevant molecular signaling alterations that promote the generation of CSCs in BL-DCIS and the progression of BL-DCIS to invasive breast cancer, as well as the infuence of the tissue microenvironment on CSCs and the invasive transition. Finally, we discuss the translational implic-ations of these fndings for the prognosis and prevention of BL-DCIS relapse and progression.
文摘An increasing body of evidence supports a stepwise model for progression of breast cancer from ductal carcinoma in situ(DCIS) to invasive ductal carcinoma(IDC). Due to the high level of DCIS heterogeneity, we cannot currently predict which patients are at highest risk for disease recurrence or progression. The mechanisms of progression are still largely unknown, however cancer stem cell populations in DCIS lesions may serve as malignant precursor cells intimately involved in progression. While genetic and epigenetic alterations found in DCIS are often shared by IDC, m RNA and mi RNA expression profiles are significantly altered. Therapeutic targeting of cancer stem cell pathways and differentially expressed mi RNA could have significant clinical benefit. As tumor grade increases, mi RNA-140 is progressively downregulated. mi R-140 plays an important tumor suppressive role in the Wnt, SOX2 and SOX9 stem cell regulator pathways. Downregulation of mi R-140 removes inhibition of these pathways, leading to higher cancer stem cell populations and breast cancer progression. mi R-140 downregulation is mediated through both an estrogen response element in the mi R-140 promoter region and differential methylation of Cp G islands. These mechanisms are novel targets for epigenetic therapy to activate tumor suppressor signaling via mi R-140. Additionally, we briefly explored the emerging role of exosomes in mediating intercellular mi R-140 signaling. The purpose of this review is to examine the cancer stem cell signaling pathways involved in breast cancer progression, and the role of dysregulation of mi R-140 in regulating DCIS to IDC transition.
文摘BACKGROUND Metaplastic breast carcinoma(MBC)is a rare subtype of invasive breast cancer comprising malignant epithelial and mesenchymal cells.Compared with other invasive breast cancers,MBC is not only histologically distinctly heterogeneous but also has a rapid and aggressive growth pattern,which leads to a significant risk of recurrence and mortality.CASE SUMMARY In this study,we report the case of a patient with a large left breast mass diagnosed with bilateral invasive ductal carcinoma in both breasts after a preoperative core needle aspiration biopsy of the bilateral breast mass.The patient received neoadjuvant chemotherapy and underwent bilateral breast modified radical mastectomy.Postoperative pathology suggested carcinosarcoma with predominantly chondrosarcoma in the left breast and invasive ductal carcinoma(luminal B)in the right breast.As the patient did not achieve complete pathological remission after six cycles of neoadjuvant chemotherapy,we administered six months of intensive capecitabine treatment.Then the patient was switched to continuous treatment with endocrine therapy using letrozole+goserelin,and the patient is currently in stable condition.However,as MBC of the breast is concurrently diagnosed with chondrosarcoma differentiation,our case is sporadic.CONCLUSION Given the variety of immunohistochemical types of bilateral breast cancer,achieving effective chemotherapy should be a key research focus.
文摘Breast cancer is the second leading cancer in the world. <span style="font-family:Verdana;">The long-term</span><span style="font-family:Verdana;"> exposure </span><span style="font-family:Verdana;">of</span><span style="font-family:Verdana;"> some metallic compounds induces different forms of cancer, including breast cancer. Trace elements are essential metals for the physiological functions of the cell on a molecular level and also contribute </span><span style="font-family:Verdana;">in</span> <span style="font-family:Verdana;">treatment</span><span style="font-family:Verdana;"> of many diseases. </span><span style="font-family:Verdana;">The aim of study was</span><span style="font-family:Verdana;"> to compare the level of essential trace elements, sodium, potassium, calcium, iron, and zinc in breast cancer patients with normal healthy adult women. Total forty-five patients (age range from 25</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">-</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">73 years) were included in this study and divided into three groups according to three different stages of breast cancer including tumor-II, tumor-III </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> tumor-IV. Blood was collected from all participants after taking history, clinical data </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> taking consent. However, about fifteen non-cancer healthy women in </span><span style="font-family:Verdana;">age</span><span style="font-family:Verdana;"> range from 26</span></span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">-</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">69 years were subjected to this study. The elemental concentrations were determined through atomic absorption spectrophotometer </span><span style="font-family:Verdana;">subsequent to</span><span style="font-family:Verdana;"> microwave-induced acid digestion. The results of Na, K, Zn, Fe, Ca, were observed </span></span><span style="font-family:Verdana;">to </span><span style="font-family:Verdana;">decrease in blood samples of breast cancer patients as compared to non-cancer subjects. The results are reliable with other numerous literature reported studies, the efficiency, and deficiency of these trace metals may contribute </span><span style="font-family:Verdana;">an </span><span style="font-family:Verdana;">important</span><span style="font-family:Verdana;"> role in the progress of breast cancer.</span>
文摘Breast cancer,particularly Invasive Ductal Carcinoma(IDC),is a primary global health concern predominantly affecting women.Early and precise diagnosis is crucial for effective treatment planning.Several AI-based tech-niques for IDC-level classification have been proposed in recent years.Processing speed,memory size,and accuracy can still be improved for better performance.Our study presents ECAM,an Enhanced Channel-Wise Attention Mechanism,using deep learning to analyze histopathological images of Breast Invasive Ductal Carcinoma(BIDC).The main objectives of our study are to enhance computational efficiency using a Separable CNN architecture,improve data representation through hierarchical feature aggregation,and increase accuracy and interpretability with channel-wise attention mechanisms.Utilizing publicly available datasets,DataBioX IDC and the BreakHis,we benchmarked the proposed ECAM model against existing state-of-the-art models:DenseNet121,VGG16,and AlexNet.In the IDC dataset,the model based on AlexNet achieved an accuracy rate of 86.81%and an F1 score of 86.94%.On the other hand,DenseNet121 outperformed with an accuracy of 95.60%and an F1 score of 95.75%.Meanwhile,the VGG16 model achieved an accuracy rate of 91.20%and an F1 score of 90%.Our proposed ECAM model outperformed the state-of-the-art,achieving an impressive F1 score of 96.65%and an accuracy rate of 96.70%.The BreakHis dataset,the AlexNet-based model,achieved an accuracy rate of 90.82%and an F1 score of 90.77%.DenseNet121 achieved a higher accuracy rate of 92.66%with an F1 score of 92.72%,while the VGG16 model achieved an accuracy of 92.60%and an F1 score of 91.31%.The proposed ECAM model again outperformed,achieving an F1 score of 96.37%and an accuracy rate of 96.33%.Our model is a significant advancement in breast cancer diagnosis,with high accuracy and potential as an automated grading,especially for IDC.
文摘The present study aimed to investigate the possibility of using dual-energy computed tomography (CT) before therapy to discriminate between normal breast tissue and tumor tissue in patients with breast cancer, without the need to use a contrast medium. The following patient data were extracted by interview and from the hospital’s radiology information system: height, weight, age, menstrual cycle, CT images of normal tissue and tumors with or without contrast medium, and the histopathological diagnosis of the aspiration biopsy. The median age of the 43 participants was 56 years (range, 30 - 80 years). The CT values were evaluated using a clinical analytical program based on the three-material decomposition technique. Breast cancer was classified into ductal carcinoma in situ, invasive ductal carcinoma, invasive lobular carcinoma, fibromatosis-like metaplastic carcinoma, and apocrine carcinoma. In all conditions, regardless of contrast medium, the CT values of tumor tissues were higher than those of normal breast tissue, indicating the effectiveness of dual-energy CT (DE-CT) in the diagnosis of breast cancer. By contrast, DE-CT showed limited potential for distinguishing ductal carcinoma in situ from invasive ductal carcinoma. There have only been a few reports regarding CT examination of breast cancer, and it is expected this study encourage the development of DE-CT imaging to improve tumor detection in patients with breast cancer.
文摘Background： Blood oxygenation level-dependent magnetic resonance imaging （BOLD-MRI） is a functional MRI technique which involves using the paramagnetic properties of deoxyhemoglobin to image the local tissue oxygen concentration. The purpose of this study was to investigate whether BOLD-MRI could evaluate hypoxia and angiogenesis of breast invasive ductal carcinoma （IDC）. Methods： Ninety-eight female patients with IDC were retrospectively included in this research. All patients underwent breast BOLD-MRI at 3.0 T before surgery. R2＊ values of BOLD-MR1 were measured. The expression of carbonic anhydrase IX （CA IX） and vascular endothelial growth factor （VEGF） was analyzed by immunohistochemistry. Spearman＇s correlation analysis was used to correlate R2＊ value with CA IX and VEGF levels. Results： Heterogeneous intensity on BOLD-MRI images was the main finding of IDCs. The mean R2＊ value was 52.8 ± 18.6 Hz. The R2＊ values in patients with axillary lymph node metastasis were significantly higher than the R2＊ values in patients without axillary lymph node metastasis （t = 2.882, P = 0.005）. R2＊ values increased with CA IX level and positively correlated with the level of CA 1X （r = 0.616, P 〈 0.001）; however, R2＊ value had no significantly correlation with the level of VEGF （r = 0.110, P = 0.281）. Conclusion： B OLD-MRI could noninvasively evaluate chronic hypoxia of IDC, but not angiogenesis.
